THE LYCEUM OF MONTEREY COUNTY'S SPELLING BEE Photo and LIABILITY RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE

Name of Student Participant *

Name of Student Participant

First Name

Last Name

Name of Parent or Guardian *

Name of Parent or Guardian

First Name

Last Name

Parent or Guardian Email

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Phone Number During Conference *

Contact Phone Number During Conference

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Name of Emergency Contact Person *

Name of Emergency Contact Person

First Name

Last Name

Emergency Contact Phone Number *

Emergency Contact Phone Number

(###)

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This activity presents the risk of injury. This exculpatory release confirms that the participant who signs below accepts all aspects of that risk.

Section 1 *

I, the undersigned legal parent/guardian, hereby voluntarily expressly and affirmatively execute this agreement in return for permission for my child listed under "Name of Student Participant" above, to participate in The Lyceum of Monterey County’s Spelling Bee competition, scheduled to take place on Feb 25th of 2017 at San Benancio Middle School. I fully understand and appreciate the dangers, hazards, and risks inherent in the activity, which dangers include but are not limited to personal injury or death as a result or accident, act of God, or physical exertion or damage to personal property.

Section 2 *

Knowing the dangers, hazards, and risks of such activities, and in consideration of my child being permitted to participate in the activity, I, the undersigned, agree to assume all the risks and responsibilities surrounding my child's participation in the activity, and in advance release, waive, forever discharge, and covenant not to sue The Lyceum of Monterey County, its governing board, officers, agents, employees, (hereafter called the ‘Releasees’), from and against any and all liability for any harm, injury, damage, claims, demands, actions, causes of action, costs, and expenses of any nature that my child may have or that may hereafter accrue to me, arising out of or related to any loss, damage, or injury, including but not limited to suffering and death, that may be sustained to my child or by any property belonging to my child, whether caused by the negligence or carelessness of the Releasees, or otherwise, while in, on, upon, or in transit to or from the premises where the activity, or any adjunct to the activity, occurs or is being conducted.

Section 3 *

I understand and agree that Releasees are granted permission to authorize emergency medical treatment, if necessary. I understand and agree that Releasees assume no responsibility for any injury or damage which might arise out of or in connection with such authorized emergency medical treatment.

Section 4 *

It is my express intent that this release and hold harmless agreement shall bind child, the participant, the participant’s family, estate, heirs, administrators, personal representatives, or assigns and shall be deemed as a ‘Release, Waiver, Discharge and Covenant’ not to sue the above-named Releasees. I further agree to save and hold harmless, indemnify, and defend Releasees from any claim by me or my family, arising out of participation in The Lyceum of Monterey County’s Spelling Bee competition to take place February 25th, 2017.

Section 5 *

In signing this Release, I acknowledge and represent that I have fully informed myself of the content of the foregoing waiver of liability and hold harmless agreement by reading it before I sign it, and I understand that I sign this document as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written statement, have been made. I further state that I am at least eighteen (18) years of age and fully competent to sign this agreement; and that I execute this release for full, adequate, and complete consideration fully intending to be bound by the same. I further state that there are no health-related reasons or problems which preclude or restrict the participating minors’ participation in this activity, and that I have adequate health insurance necessary to provide for and pay any medical costs that may be attendant as a result of injury.

Section 6 *

I further agree that this Release shall be construed in accordance with the laws of California. If any term or provision of this Release shall be held illegal, unenforceable, or in conflict with any law governing this Release the validity of the remaining portions shall not be affected thereby.

Section 7 *

I have read the above liability release statement and fully understand and accepts all aspects of that risk.

Section 8: Photo Permission *

I give my consent for The Lyceum of Monterey County to use photos, videos, and audio or audio tape that includes my child for the purpose of publicizing and promoting Spelling Bee and other Lyceum programs. I understand that the images, child name, and school, and/or voice recordings may be published in newspapers or magazines, on social media sites, on the World Wide Web, and may be broadcast on television and/or radio. Other private information such as addresses, phone numbers, or email will NOT be published.

Parent Signature *

I understand that checking the boxes in sections 1 through 9 above, and clicking the "submit" button acknowledges that I have read, understand, and agree to the terms and conditions outlined herein as a condition of my child’s participation in The Lyceum of Monterey County's Spelling Bee competition for which I am registering him/her. I further understand that checking the boxes in sections 1 through 9 above and clicking the “Submit” button below has the same force of law as my original signature. I understand that I am not obligated in any way to make such agreement, except as a prerequisite to my child's participation in this program.

Thank you for registering your child for our Spelling Bee competition. We have received your waivers and your registration is now complete.

If you have questions, please contact general@lyceum.org or 831-372-6098.